Editorial: Closing the Obamacare youth gap

Considering the antagonism to the Affordable Care Act among politicians in Republican-controlled states such as Florida, it is encouraging that the Obama administration has succeeded in getting millions of Americans signed up for new health insurance. But for health care reform to succeed, more young people need to get coverage through the online marketplaces. This is where government can help with outreach and public information, and Tampa Mayor Bob Buckhorn is showing others how it can be done.

Considering the antagonism to the Affordable Care Act among politicians in Republican-controlled states such as Florida, it is encouraging that the Obama administration has succeeded in getting millions of Americans signed up for new health insurance. But for health care reform to succeed more young people need to get coverage through the online marketplaces. This is where government can help with outreach and public information, and Tampa Mayor Bob Buckhorn is showing others how it can be done.

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The encouraging enrollment numbers released this week indicate that 2.2 million Americans have signed up for coverage, including 158,000 Floridians. The surge in interest during the month of December suggests that the federal marketplace website, healthcare.gov, has overcome its frozen screens and other malfunctions. The launch fiasco two months earlier provided an opening for critics to say health care reform should be ditched, and the Obama administration should have been better prepared. Now that the website works better, the same critics are turning their attention to the less than expected number of young people signing up for coverage to warn of future premium increases in the marketplaces and new government bailouts. Those warnings are overblown and premature.

About a quarter of the marketplace enrollees are in the 18-34 age group. In Florida, about 20 percent of people who have signed up are in this age range. That won't be enough to keep future health insurance rates in check. Premiums of younger, healthier enrollees are needed to off-set older, sicker ones. But the experience of Massachusetts is comforting. After the state implemented a similar program, including an individual mandate that imposed a penalty for going without insurance, younger people waited until close to the deadline to sign up. The same will probably be true under the federal Affordable Care Act, which has a deadline for getting coverage and escaping tax penalties of March 31.

Gov. Rick Scott has a responsibility to Florida's nearly 4 million uninsured to get as many covered as possible. He should be initiating public information campaigns and other outreach. Instead, he has thrown up roadblocks. The state refused to allow federally funded enrollment specialists known as navigators to operate out of state-run health department offices, forcing counties to work around the order. House Speaker Will Weatherford and other House Republicans callously refuse to expand Medicaid, leaving roughly 1 million poor Floridians without coverage and $51 billion in federal money in Washington rather than flowing to Floridians over the next decade. Inconceivably, Republican legislators already have already announced that Medicaid expansion is not on the agenda for this spring's legislative session, but health care reform supporters should step up the pressure.

Contrast Tallahassee's ideological stubbornness with the commendable initiatives launched by Buckhorn. The Tampa mayor announced Monday during a visit from Health and Human Services Secretary Kathleen Sebelius that navigators will be available at nine of the city's recreation departments to help people enroll through the online marketplaces. Also, the city's firefighters and rescue workers will be equipped with information on health coverage options when responding to emergency calls.

Despite Republican efforts to deny access to health care, Americans are signing up for health insurance in the millions and Floridians are signing up in the tens of thousands. These are promising signs, but there is much more work to be done.